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Flashcards in Ketorolac Deck (23):
1

What is the trade name of Ketorolac?

Toradol

2

What is the drug classification of Ketorolac?

Non-steroidal anti-inflammatory drug (NSAID)

3

What is Ketorolac a derivative of and its uses?

-Derivative of Pyrrole acetic acid used to treat moderate to severe pain, gout, ankylosing spondylitis, OA, and for post-surgical analgesia
-useful in supplementing opioids by potentiating their anti-nocioceptice action

4

What is the MOA of Ketorolac?

-Reduces inflammatory response by inhibiting cyclooxygenase (COX) 1 AND 2, which decreases the synthesis of eicosanoids
-also inhibits prostaglandin synthesis by decreasing the activity of COX
-blocks conversion of arachidonic acid to prostaglandins
-decreases production and release of prostaglandins
-Analgesic, antipyretic, anti-inflammatory

5

When is the onset of action of Ketorolac?

10 minutes

6

When is the peak effect of Ketorolac?

2-3 hours

7

What is the e 1/2 t of Ketorolac?

5 hours

8

When is Ketorolac's e 1/2t prolonged? by how much approx?

30%-50% prolonged in the elderly (6-8 hours) so cut the dose in HALF!

9

How is Ketorolac metabolized and eliminated?

-metabolized by the liver, principally by flucoronic acid conjugation
-eliminated by the kidneys (60% unchanged)

10

Is ketorolac protein bound?

99% protein bound!

11

What are the common side effects of Ketorolac?

-Prolongs bleeding time and decreases platelet aggregation
-Bronchospasm in asthma/ aspirin sensitivity
-GI bleeding/PUD/Dyspepsia (inhibits prostaglandin production that maintains normal gastric and duodenal mucosa)
-Peripheral edema
-nausea
-sedation
-ARF
-Anaphylaxis
-Stevens-Johnson Syndrome
-Ulceration/ perforation

12

What are the contraindications to administration of Ketorolac?

-GI or intracranial bleeding
-Urticaria
-Coagulation defects
-Asthma
-Labor and Delivery: d/t may inhibit uterine contractions and affect fetal circulation
-3rd trimester pregnancy
-cross tolerance with ASA and other anti-coags

13

What are some drug interactions with Ketorolac?

-increases plasma lithium [ ]
-increased risk of bleeding if given with oral anticoags
-May increase Warfarin lvls
-Displaces other highly protein bound drugs
-Probencid increases the level of Ketorolac

14

What is the oral dose of Ketorolac?

10mg q4-6hr

15

What is the IV/IM dose of Ketorolac?

30-60mg; then 15-30mg q6hrs

16

What is the maximum daily dose of Ketorolac? maximum days of use?

120mg; do NOT exceed 5 days of use

17

When should you use smaller doses of Ketorolac?

-elderly
-prostaglandin dependent renal failure patients
-renal insufficiency
-may see elevated liver enzymes in liver failure/impairment patients

18

What is important to remember about Ketorolac (NSAIDS) vs. ASA?

IS REVERSIBLE

19

What is the Vd of KEtorolac?

very small

20

What reactions can occur if Ketorolac is given to aspirin-sensitive patients?

anaphylactoid and asthma reaction

21

What is unique about Ketorolac vs the other NSAIDS?

it is the ONLY available IV NSAID

22

What is an advantage of Ketorolac vs opioids?

NO ventilatory or cardiac depression

23

What is the DOA of Ketorolac?

6-8hours